Irreducible acute anterior dislocation of the shoulder: interposed scapularis.

Case report. A 55-year-old man felt heavily, dislocating his left shoulder. He was seen within an hour of injury, and radiographs confirmed an anterior dislocation with no associated fracture (Fig. 1). With the patient sedated, manipulative reduction by Kocher’s manoeuvre was attempted. This appeared to be successful, and an anteroposterior radiograph was thought to confirm reduction, although the glenohumeral relationship was not entirely normal (Fig. 2). However, the patient immediately complained of severe pain in the shoulder and an axillary radiograph was obtained, which confirmed persistent anterior subluxation (Fig. 3). A further manipulation was attempted under general